Medicare overhaul no excuse to lift fees

The federal Health Minister has angrily denied that the Government's overhaul of Medicare will give the green light to a surge in patient charges as medical leaders have forecast.

"Doctors cannot use the Government's package as an excuse to increase their fees," Kay Patterson said yesterday.

Senator Patterson was responding to forecasts of increases in up-front fees being made by leaders of doctors' groups, including the president of the Australian Medical Association, Kerryn Phelps.

Higher out-of-pocket costs for patients who do not qualify for concession cards had become "inevitable" after governments on both sides had allowed the value of the Medicare rebate to fall, Dr Phelps said this week.

"I don't think that we can assume that middle-income earners can't pay $20 when they go to see a GP," she said, "when they pay to see a hairdresser, an accountant, a lawyer and any other professional person."

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But Senator Patterson said the Government's package "does not give the doctors the green light to charge middle-income families more to see a GP, as has been claimed by some vocal doctors".

She said there was nothing in the wider-ranging charges - likely to be announced next week - that would cause doctors to increase their fees.

Such billing practices are illegal under Medicare rules. The Herald understands that the package will allow doctors the billing perk, provided that they bulk-bill all pensioner patients.

The Government will also offer payments totalling more than $900million over four years to doctors in return for bulk-billing pensioners. The payments are expected to give city doctors about $1 extra per service but higher payments to those in outer suburbs and country areas.

Senator Patterson said she rejected doctors' claims that the incentives were not enough and would force them to charge patients more, but acknowledged that doctors would be free to charge what they liked.

"Some people may pay a gap, others will be bulk-billed, depending on their doctors' billing practices ... There will be no means test," she said.

The Opposition yesterday released figures showing that the bulk-billing rate - where doctors only charge Medicare and the patient does not pay - had fallen to under 30per cent in one electorate, Indi, in northern Victoria.

The toughest hit federal electorate in NSW was Eden-Monaro, where only 38per cent of GP services were bulk-billed, compared to the national average of 69.6per cent.

Labor's health spokesman, Stephen Smith, said the proposed changes would leave low-income families not on a pension vulnerable to higher bills.

The Australian Democrats have said they will oppose the changes in the Senate.

The biggest general practitioners' organisation yesterday said the "major changes" in GP financing were likely to include a choice as to whether doctors opted into the package and received the incentive payments for bulk-billing pensioners.

The president of the Australian Divisions of General Practice, Dr Rob Walters, said there would be "a divergence of views" about the package and each GP would have to decide which was best for them.